The purpose of the proposed study is to describe the natural history of the transition to menopause, integrating the endocrine changes of the menopausal transition with features of the social context in which they occur. Perceived stress, ovarian function, physiologic stress arousal indicators (cortisol and catecholamines, adrenal androgens) will be studied in relation to symptoms and symptom management strategies. Socialization, personal factors, health behaviors and health status will be studied as they modify the relationships between perceived stress, ovarian function, stress arousal hormones, symptoms and symptom management strategies. The proposed research will involve 150 women who have participated in an ongoing longitudinal study of midlife (Seattle Midlife Women's Health Study) from 1990 to 1995. Women will participate in an annual in-home interview including measures of health status and a health history update, keep a daily bleeding calendar, provide monthly early am urine specimens for analysis for ovarian steroids (estradiol, estrone, testosterone), adrenal androgens (DHA and DHAS), cortisol and catecholamines. Women will also complete a health update annually that includes selected measures of perceived stress, personal factors, socialization, health status changes, health behaviors (Food Frequency Questionnaire, exercise questionnaire, smoking and alcohol use questions) and use of health services for symptom management. The findings of this study will contribute to an integrative understanding of how biological changes of the menopausal transition and the context in which they occur relate to symptoms that cause distress and influence women's use of health services during midlife.